The association of renal artery calcification with hypertension in community-living individuals: the multiethnic study of atherosclerosis

• Hypertension (HTN) is a common risk factor for cardiovascular disease.
• Renal artery calcification is associated with HTN in a multiethnic cohort.
• Renal artery calcification may signal atherosclerosis that contributes to the kidney's regulation of HTN.

Hypertension (HTN) is a modifiable risk factor for cardiovascular disease (CVD). Renal artery calcium (RAC) may signal the presence of flow-limiting atherosclerotic disease that may contribute to changes in the kidney's regulation of blood pressure. We hypothesized that RAC is independently associated with HTN. We examined a multiethnic cohort of 1285 participants who underwent abdominal computed tomography scans in five US communities. After adjustment for age, gender, race/ethnicity, CVD risk factors, abdominal aortic calcium score, and kidney function, the presence of RAC was associated with a 50% higher odds of HTN (odds ratio: 1.54; 95% confidence interval 1.11–2.13). Similarly, the presence of RAC was associated with a 8.5 mm Hg higher systolic blood pressure, a 2.1 mm Hg higher diastolic blood pressure, and a 7.4-mm Hg higher pulse pressure. In conclusion, independent of CVD risk factors, abdominal aortic calcium, and kidney function, the presence of RAC is associated with HTN prevalence.